Today was a bit harder to convince Corey to “go to the gym”. She wasn’t very happy to work with her coaches but as soon as each coach greeted her, she was too polite to tell them she didn’t want to see them. She wanted to go home, “it’s not fun here”…that was until we started to “play some games”.
It’s difficult to explain to Corey that her mind thinks she can do an activity but her muscles aren’t ready yet. She cannot comprehend why she needs help ~ “I can do it myself”. She will look at a particular limb, stare, concentrating incredibly hard and yet there is no motion. Frustration hits, muscle tone kicks in making movement impossible and her temper flares. We allow her to vent, she takes a deep breath and then she tries again ~ Patience is exhausting!
After several tries she allows us to help her. Each coach is wonderful with her. They calmly and confidently reassure her that she can move the way she’d like to, it’s just a matter of time before the muscles remember what her mind already knows what to do. The muscles have been asleep for a long time but they are slowly waking up.
Ted is working with Corey on upper body control and core muscle development. Without upper body strength, Corey will not properly walk. He is still assessing her control, strength and movement before we continue to push her long distance walking.
Jeanine is focusing on her upper body as well, with an emphasis on her left arm. The ladies worked on stretching exercises for almost 30 minutes; retraining the muscles to repeat familiar movements. By the end of the session, Corey’s left arm was fully extended down to her side and she lifted it; bending at the elbow, to touch her chin. Another first!
Jeanine also tried a new therapy tool with Corey today. It’s called a Mirror Box. Picture a rectangular black box, closed on all sides. There is a hole on the top and bottom. When the box is on its side, the hole acts as a tunnel. Corey slips her left arm into the tunnel. There is a mirror on the outside right wall of the box (facing her right arm/hand).
Corey looks at the mirror to see the reflection of her right arm/hand. Looking at the reflection of the right arm, each movement appears as if the left arm is making the same motion. The brain is tricked into thinking the reflection is actually the left arm moving. In actuality, the left arm is in the box, motionless.
After the right arm patterns the same movement, the box is removed and the left arm mimics the right arms pattern. This therapy tool is used for amputee’s dealing with phantom pain. Research shows that using this tool actually forges new pathways in the brain in order to regenerate muscle movement. Our first trial was not as successful as Jeanine would have hoped, but she is convinced it will accelerate Corey’s movement with subsequent weekly trials.
This afternoon’s Speech session was dedicated to swallowing. Corey is working towards swallowing thin liquids. The first 3-4 swallows are successful but #4-6 causes her to choke and aspirate. We do not understand if its fatigue and/or her mouth, neck and tongue muscles still have to develop. We have to be extremely careful with Corey’s swallowing food or liquids. Aspiration can lead to Pneumonia which is one of the leading causes of fatal complications in the TBI community. We continue to take her temperature multiple times per day to monitor the slightest change that might hint towards developing pneumonia.
Corey I wish you could see what we see. The accomplishments you’ve made and continue to make, including this week, are amazing. It’s okay to be frustrated and impatient. You use it to your advantage ~ to prove that you CAN do it. Your legs and arms WILL move the way you intended. You will get to the point where it will become effortless again. You won’t have to stare and think about the motion; it will move instinctually.
I am especially proud of your determination to Never Give Up and Never Give In as well as your willingness to try new tools and games with your coaches. Your drive to prove to us that you can do it will guarantee that you will do it! It’s a matter of time…xoxo